Organization · Type 2 NPI

Morningside Primary Care Medical Center MC Inc A Nevada Corporation

Non-Pharmacy Dispensing Site · Los Angeles, CA

NPI number 1255749099 Active

Practice location

617 W Manchester Ave
Los Angeles, CA 90044-5718

Call (323) 778-6215 Map

Mailing address

5626 Oberlin Dr, Suite 110
San Diego, CA 92121-1705

Specialties and licenses

Taxonomy	Code	License
Non-Pharmacy Dispensing Site Primary	332900000X	45227 (CA)

Non-Pharmacy Dispensing Site: A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)

9 other providers at this address

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NPI record

NPI: 1255749099
Entity type: Organization (Type 2)
Issued: Jul 24, 2014
Last updated: Jul 24, 2014
Status: Active
Subpart: Yes of Medvantx, Inc.

Other names

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Morningside Primary Care Medical Center Inc · doing business as

Authorized official

Kenny Heine
VP of Operations
(858) 964-1506

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1255749099

Morningside Primary Care Medical Center MC Inc A Nevada Corporation's National Provider Identifier is 1255749099, issued on Jul 24, 2014. The primary taxonomy on file is Non-Pharmacy Dispensing Site (332900000X), and the practice location is in Los Angeles, CA. The record was last updated on Jul 24, 2014.